Overview of Ultrasound Therapy

Ultrasound was first documented for use in 1958 by a team led by Ian Donald in Glasgow. They used it as a tool for diagnosing conditions in the fields of pregnancy care and women’s health. Now, ultrasound has many uses. These include monitoring a baby in the womb, helping to guide injections into joints, assisting in the placing of arterial lines, and helping to diagnose conditions involving the joints. Because it doesn’t involve radiation, is relatively inexpensive, and can be easily moved, ultrasound is a great tool for healthcare providers.

In addition to diagnosis, ultrasound can also be used for treatment. For example, it can be used to help treat conditions like osteoarthritis (a condition that causes joints to become painful and stiff), various conditions affecting the shoulder, and myofascial pain (a type of muscle pain). Ultrasound is used in a procedure called atrial ablation, a treatment to correct heart rhythm problems. It is also used in a procedure called extracorporeal shockwave lithotripsy, a treatment that breaks up kidney stones. Moreover, it can help to speed up the healing of fractures, be used for limited skin tightening procedures, and even treat benign (non-cancerous) and malignant (cancerous) soft tissue tumors when used together with MRI scans.

All ultrasound machines work the same way, no matter the power setting or manufacturer. They create an electrical signal that causes crystals inside the ultrasound probe to vibrate. This creates waves at frequencies beyond what humans can hear (20 hertz to 20000 hertz). This produces what’s known as the ‘piezoelectric effect.’ This energy can be transferred to the surface of the body or focused to affect tissues deeper under the skin. Different tissues in the body absorb this energy at different rates. For example, tissues with more protein content like muscle and bone absorb the energy faster than tissues with higher water content, like fat. This energy can be focused to treat deeper tissues without affecting the surface ones.

Anatomy and Physiology of Ultrasound Therapy

Therapeutic ultrasound is a treatment method originally used for its ability to transfer heat energy through high-speed sound waves. These waves vibrate and heat the body’s tissues under an ultrasound probe. This heat can cause blood vessels to enlarge, which allows more oxygen and nutrients to be delivered to cells, potentially speeding up their activity. This is why physical therapists often use low-power ultrasound to treat pain and shoulder problems. Modern ultrasound equipment has introduced new ways to use this heat. For instance, high-intensity focused ultrasound (HIFU) uses a curved probe to concentrate waves at a certain depth. This technology can be paired with scans, such as an MRI, for various treatments, including uterine fibroids, prostate cancer, skin issues, and abnormal heart tissue in people with irregular heart rhythms.

Another important process in ultrasound therapy is cavitation. This occurs when pressure changes in a liquid, causing bubbles to form. The high-speed sound waves from the ultrasound probe cause these pressure differences. When the bubbles hit solid objects, they burst and create shockwaves. These shockwaves can put pressure on solid surfaces and create movement in the liquid. For example, in extracorporeal shockwave lithotripsy (ESWL), they break up kidney stones so the body can remove them more easily. They can also increase the effectiveness of therapies that break down blood clots.

Ultrasound diathermy is another use of ultrasound, where its energy is turned into heat. This raises the temperature of deep tissues like muscles, which can help them relax.

Why do People Need Ultrasound Therapy

Advancements in technology and in-depth research have led to ultrasound therapy becoming an approved treatment by the FDA in various medical fields. Ultrasound therapy can generally be categorized into two types: ‘low power’ and ‘high power’.

‘High power’ therapy comprises procedures like Lithotripsy (breaking down kidney stones) and High Intensity Focused Ultrasound (HIFU, used to treat tumors). ‘Low power’ therapy, on the other hand, includes treatments like stimulating bone healing, sonophoresis (using ultrasound to make the skin more permeable for medicine), and diathermy (using heat produced by ultrasound for pain relief and relaxation).

When a Person Should Avoid Ultrasound Therapy

Some medical procedures might not be safe for some people, depending on their current health status. These are called contraindications and they’re tailored to each procedure. Here are some examples:

– ESWL, or Extracorporeal Shock Wave Lithotripsy, a procedure that uses shock waves to break up stones in the kidney, bladder, or ureter (the tube that connects your kidneys to your bladder) might not be advisable for people with the following conditions: infection; having a huge amount of stones bigger than 2.5 cm; blood disorders that affect clotting; uncontrolled high blood pressure; or pregnancy.

– Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS), a procedure that uses heat from ultrasound to target specific areas of the body, might not be advisable for people with a heart pacemaker or other devices implanted inside their body.

– Ultrasound diathermy, a procedure that uses sound waves to generate heat in a body part, might not be safe for those who have a broken bone, cancer, artery hardening, if it would need to be applied to the eyes or spine, if they have an active infection, or if they have ischemic tissues (restricted blood flow to parts of the body).

Equipment used for Ultrasound Therapy

Ultrasound therapies all work by using an electrical current sent through a handheld probe. This probe produces heat and creates tiny bubbles (cavitation) which helps to achieve the desired medical outcome. The probe has special crystals that generate ultrasound waves, and a safe, skin-friendly gel is applied to your skin to help carry these waves into your body’s tissues. High-intensity focused ultrasound (HIFU) procedures use a specially shaped probe that can focus the ultrasound waves deep beneath the surface of the body, and they are often combined with imaging technology to make the procedure safer and more effective.

Imaging technologies like ultrasound and MRI can help make therapeutic ultrasound treatments more accurate and effective when used together. For example, magnetic resonance imaging (MRI) can be used in a method called MR-guided ultrasound (MRgUS) to monitor the temperature of the tissues around the targeted area, such as a fibroid or tumor, while also focusing the ultrasound waves on the specific area. This approach can help to prevent damage to healthy, non-cancerous tissue. Ultrasound imaging can also be used with HIFU because it is less expensive, provides real-time images, and works well with implanted devices. However, MRI is often preferred for many HIFU procedures because it provides a wider view and clearer images.

Who is needed to perform Ultrasound Therapy?

In most American treatments, both doctors and support staff play important roles. Health professionals such as physicians usually handle therapeutic ultrasound, a technique used to promote healing in the body. Support staff, on the other hand, help monitor patients and the machines used.

However, when it comes to using ultrasound for bone and muscle issues (musculoskeletal), it’s a bit different. This special type of ultrasound, known as low-intensity ultrasound, is considered safe and poses few risks. As a result, many physical therapists (health professionals who help to restore movement and function when someone is affected by injury or illness) and doctors can carry out this treatment on their own, without needing much, if any, help.

Preparing for Ultrasound Therapy

If a patient needs ultrasound treatment for soft tissue tumors, the doctor will first perform an MRI. This helps the doctor identify where the tumor is and plan how to position the patient during the treatment. The images from the MRI will be compared to any previous images to help guide the patient’s positioning.

The preparation for ultrasound treatment for musculoskeletal issues is usually brief. The doctor will check the patient’s skin for any burns, rashes, infections, or signs of active bleeding. The ultrasound equipment is also thoroughly checked before the treatment begins to ensure everything functions as it should.

How is Ultrasound Therapy performed

Therapeutic ultrasound treatments are FDA-approved procedures that have some similarities. All these therapies use a tool known as a transducer to send ultrasound waves into your body. The transducer is put directly on your skin with a special gel. This gel helps the ultrasound waves reach the targeted area in your body effectively. Different types of gels have been tested, but ones that don’t cause allergies seem to work best.

Here is how some of these treatments work.

ESWL (Extracorporeal Shock Wave Lithotripsy):

In this therapy, used mainly for breaking down kidney stones, the process is as follows:

– You’ll lie down on a special table that uses X-rays (fluoroscopic table).
– The doctor will check the X-rays and adjust your position so the stone can be targeted accurately.
– You may receive a sedative or spinal anesthesia as the shockwaves used in this treatment can cause discomfort.
– The table will be adjusted vertically to ensure the stone is in the perfect spot (“focus”) for the ultrasound waves.
– You’ll then receive bursts of shockwaves at a rate of about 120 per minute.

HIFU (High Intensity Focused Ultrasound):

This therapy, used for various medical issues like cancer, follows these steps:

– You’ll lie down on your back, stomach, or side on a table.
– The doctor might use a device to keep the target area (like the breast) steady.
– A local anesthetic may be given for pain control.
– The doctor uses ultrasound or MRI to locate the exact tissue to be targeted.
– The HIFU probe is positioned to focus on the target tissue.
– A test ultrasound dose is delivered to the center of the target area.
– If needed, adjustments can be made to the power of ultrasound based on the depth of tissue.
– Ultrasonic waves are sent into the tissue.
– The doctor checks whether the target tissue has been destroyed using an imaging technique (that means checking if it looks different under ultrasound or heat changes under MRI)
– Further bursts of ultrasound can be given to the surrounding area until enough tissue has been destroyed.

Musculoskeletal Ultrasound Therapy:

This therapy, used to relieve pain and help healing in muscles, bones, and joints, works like this:

– You sit or lie down comfortably.
– The doctor exposes the skin over the area that needs treatment.
– The ultrasound machine is turned on with settings to deliver waves at a certain frequency (1 to 3 MHz) and a certain intensity.
– A special hypoallergenic gel is applied to your skin.
– The ultrasound is applied to your skin with a stroking motion.
– The ultrasound is kept moving across the skin while it’s being applied.
– The treatment usually lasts about 10 minutes.
– After the treatment, the gel is wiped off from your skin.
– Depending on how deep into the body the treatment needs to reach, the provider can change the frequency. 1 MHz is used to treat deeper tissues, while 3 MHz is used for more superficial tissues.

Possible Complications of Ultrasound Therapy

Ultrasound therapies are often a good choice because they don’t have a lot of risks. But one thing that can happen with low-intensity ultrasound is burns on the skin if the treatment takes too long. This is why the wand that gives off the ultrasound waves should always be moving over the skin. High Intensity Focused Ultrasound (HIFU), when combined with Magnetic Resonance Imaging (MRI), is a safer treatment because it allows doctors to keep track of the temperature of the body parts being treated. This way, it can help stop healthy tissue from getting burned or dying.

Extracorporeal Shock Wave Lithotripsy (ESWL) might have more serious risks, like internal bleeding and scarring. To avoid causing scars on kidney tissue during ESWL, doctors carefully control how long the shockwaves last and how many shockwaves are used in total.

What Else Should I Know About Ultrasound Therapy?

Ultrasound technology, initially used for diagnosis, is now widely applied for treatment purposes across various medical specialties. Low-intensity ultrasound is regularly used as a treatment for numerous sudden and long-term conditions relating to the muscles and bones. This is due to its simplicity and lower chances of complications, which make it suitable for both outpatient and inpatient treatment.

High-intensity focused ultrasound (HIFU) is a fairly new, non-invasive treatment that uses ultrasound to destroy certain tissues in the body. This method is used to treat different types of tissues and tumors without the need for surgery. Although many applications of this technology are still being tested, it is expected to be widely recognized as a safe and alternative treatment option for various abnormal tissues and tumors in the future.

Frequently asked questions

1. What specific condition or issue am I receiving ultrasound therapy for? 2. How does ultrasound therapy work and what are the potential benefits for my condition? 3. Are there any potential risks or side effects associated with ultrasound therapy? 4. How many sessions of ultrasound therapy will I need and what is the expected duration of treatment? 5. Are there any alternative treatment options for my condition and how does ultrasound therapy compare to them in terms of effectiveness and safety?

Ultrasound therapy can affect you by transferring heat energy through high-speed sound waves. This heat can cause blood vessels to enlarge, allowing more oxygen and nutrients to be delivered to cells, potentially speeding up their activity. It can also break up kidney stones and increase the effectiveness of therapies that break down blood clots. Additionally, ultrasound diathermy can raise the temperature of deep tissues like muscles, helping them relax.

You may need ultrasound therapy for various reasons. Ultrasound therapy is commonly used in physical therapy to treat musculoskeletal conditions and promote healing. It can help reduce pain, inflammation, and muscle spasms, as well as improve blood circulation and promote tissue repair. Ultrasound therapy is often used for conditions such as tendonitis, bursitis, sprains, strains, and joint stiffness. It can also be used to break down scar tissue and promote the absorption of medications into the body. However, it is important to consult with a healthcare professional to determine if ultrasound therapy is appropriate for your specific condition and to ensure that there are no contraindications or risks involved.

You should not get Ultrasound Therapy if you have a broken bone, cancer, artery hardening, if it would need to be applied to the eyes or spine, if you have an active infection, or if you have ischemic tissues (restricted blood flow to parts of the body).

The text does not provide information about the recovery time for Ultrasound Therapy.

To prepare for ultrasound therapy, the patient should have their skin checked for any burns, rashes, infections, or signs of active bleeding. The ultrasound equipment should also be thoroughly checked before the treatment begins to ensure proper functioning. Additionally, the patient may need to undergo an MRI to identify the targeted area and plan the positioning for the treatment.

The complications of Ultrasound Therapy include burns on the skin if the treatment takes too long, internal bleeding, and scarring.

The text does not provide information about specific symptoms that would require ultrasound therapy.

Ultrasound therapy is generally considered safe during pregnancy. It has been used for many years in prenatal care to monitor the baby's development and detect any potential issues. The ultrasound waves used in therapy are non-ionizing, meaning they do not have the same harmful effects as radiation. However, it is important to note that the use of ultrasound therapy during pregnancy should be done under the guidance of a healthcare professional who can determine the appropriate frequency and intensity of the treatment. Additionally, certain ultrasound procedures, such as Extracorporeal Shock Wave Lithotripsy (ESWL), are not advisable during pregnancy due to potential risks. It is always best to consult with a healthcare provider to ensure the safety and appropriateness of any medical procedure during pregnancy.

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